CDC’s Diabetes Prevention Program – Questions and Answers #2

Category: Uncategorized

Q. Is it possible for someone in private practice to offer the MDPP as a solo practitioner?

A. Solo practitioners would need to start a National DPP and obtain full CDC Recognition to apply to enroll as a Medicare Supplier for the MDPP. Individuals in private practice can also partner with existing or new programs to provide the lifestyle coaching or serve as a program coordinator as independent contractors. The program would need to obtain the solo practitioner’s NPI for the coach roster. Medicare pays the recognized Medicare Supplier, and the program would pay the practitioner providing services for lifestyle coaching.

Q. If someone is <65 and has prediabetes but is not overweight, is he/she eligible for the program (i.e., the MDPP benefit)?

A. No. Medicare beneficiaries with a body mass index (BMI) of < 25 are not eligible to participate in the Medicare DPP benefit. The Medicare criteria for the Part B benefit is a BMI of ≥ 25 and abnormal blood glucose results. The Medicare DPP is an important new benefit to help Medicare beneficiaries prevent and/or delay diagnoses of diabetes, yet it does not meet the needs of all populations with prediabetes.

A note about individuals with Medicare Advantage plans or other individuals < 65 with private insurance: It is possible that individuals with private insurance, including Medicare Advantage plans, who have prediabetes and BMI < 25, have a benefit for MNT that may cover a diagnosis of prediabetes. Individual plan benefits and coverage policies determine what services are covered benefits and terms/conditions for coverage. We encourage RDNs and organizations to confirm benefits for MNT in persons with prediabetes.

Q. How do you become a Master Trainer?

A. As of the date of the webinar, there are three organizations (Diabetes Training and Technical Assistance Center at Emory University, American Association of Diabetes Educators, and the Diabetes Prevention Support Center of the University of Pittsburgh) that currently provide Master Training. The minimum required qualifications for application to a Master Trainer Program are:

Previous completion of Lifestyle Coach Training from a CDC-recognized national provider

Affiliation with an organization that has pending or full CDC recognition

Successful delivery and experience with the National Diabetes Prevention Program

Some of the organizations also require the applicant to be a health care professional with a minimum of a bachelor’s degree in a health-related field or if not, substantive experience. There is an application form to be completed, letters of recommendation from a supervisor or a professional who can provide information about your experience and performance in delivery of a lifestyle change program, and often a phone interview. Successful applicants attend a 2-day training, similar to the Lifestyle Coach Training Program, to become qualified to become a Master Trainer. The fees range from $1500-$1650 which includes the training and the membership/agreement fee for post-training technical assistance and licensing of the training materials. Master Trainers can train lifestyle coaches in their own and partner organizations.

Q. Can RDNs in private practice order blood tests for diabetes screening?

A. The Academy recommends that RDNs refer to the Comprehensive Scope of Practice Resource for the RDN which can guide the RDN to the resources and options that can be used to evaluate whether the RDN can safely and effectively provide an expanded practice skill and advance individual practice. Case Study: Initiating Orders for Nutrition-Related Laboratory Tests for RDNs Practicing in Hospital, Ambulatory and Private Practice Settings Academy Store: http://www.eatrightstore.org/product/AE37FD36-0C17-422C-91F6-E3C9DC845986

A. Beneficiaries will have access to ongoing maintenance sessions after the MDPP core benefit (1st 12 months of the program). At the time of the webinar CMS had not placed any limits on how long CMS will pay for ongoing maintenance sessions. Eligible beneficiaries will have access to ongoing maintenance sessions after the MDPP core benefit if they achieve and maintain the required minimum weight loss of 5%. CMS is defining maintenance of weight loss, which allows a beneficiary to access ongoing maintenance sessions, as achieving the required minimum weight loss from baseline weight at any point during the previous 3 months of the core maintenance or the ongoing maintenance sessions. CMS will propose a limit on the duration of CMS payments for ongoing maintenance sessions in future rulemaking. As a reminder, there are six monthly core maintenance sessions in months 6 through 12 of the year-long program in which beneficiaries are eligible to participate, regardless of weight loss, but CMS has not issued final rules about payment for the core maintenance component or any component of the MDPP benefit.

About the Author: Joyce Green Pastors, MS, RD, CDE, VAND Member and one of the Virginia Diabetes Council Board Members, participated in a webinar on May 24th, 2017 for the Academy of Nutrition and Dietetics about diabetes prevention. We thank them for sharing information from this webinar with us.

By consuming 2-3 probiotic-rich foods daily, you are feeding the healthy bacteria in your gut that in turn can lend to a stronger immune system.

Kristen Chang

Kristen Chang is a Certified Specialist in Sports Dietetics and triathlete, currently serving as the President of the Southwest Virginia Academy of Nutrition & Dietetics. She works as the owner of the nutrition private practice Real Food For Fuel, LLC and adjunct instructor for Virginia Tech and Radford University. Kristen lives in Blacksburg, VA with her husband, Jordan, and dogs Kenya and Sunny.

Summer is a wonderful time to buy fresh produce- everything seems to be in abundance! The juicy tomatoes are making their mark on every sandwich and salad, the summer squash add their bright color and flavor to any dinner dish, and the bountiful fresh herbs can be thrown into every single meal to add a flavor profile that is complex in taste but easy in practice. What an opportune time to fill up on the local Virginia produce!

But, what about those that cannot always afford to purchase fresh produce or shop at local farmer’s markets?

The Farmers Market Nutrition Program

The Farmers Market Nutrition Program (FMNP) is supported by the VA Department for Aging and Rehabilitation Services-Division of Aging, the VA Department of Agriculture and Consumer Services, and the USDA. The FMNP provides checks to Seniors and WIC families for the purchase of local produce at Farmers Markets. The Augusta-Staunton Health Department, one of seven serving the Central Shenandoah Health District, began issuing Farmer’s Market checks 2 years ago to their WIC participants hoping to enable them to obtain fresh fruit and vegetables. This Health District is in fact the largest in Virginia, in terms of square mileage, and is filled with rural areas.

Another Challenge – Access

For some living in rural areas, access to food assistance programs is a major challenge. Through a survey the Augusta-Staunton Health Department conducted with their WIC clients, they came to understand that while their clients were enthusiastic about the possibility of receiving local produce, many did not have the time nor means of transportation to travel to their nearest Farmers Markets during their operational days.

Increasing Access – The Farmer’s Market Initiative

To address this issue and increase access to produce, the Augusta-Staunton Health Department WIC Program decided to bring the farmers market directly to the WIC location. The goal is to bring the local farmers to the Health Department on a day when WIC clients will already be coming to the Health Department for other WIC services, thereby reducing the difficulty of transportation issues.

Along with several partners:

Project GROWS, a non-profit farm located in Verona

Troyer’s Produce located in Waynesboro

JMD Farms located in Staunton

Project GROWS, who acts as the Fiscal Manager, was chosen for this joint venture

both Project GROWS and the WIC Program have common goals of improving the health of young children through access to nutritious foods

because of their experience is successfully running two other Farmers Markets in Augusta County.

The WIC participants are able to come in for their appointments, check-ups and nutrition education programs, receive their Farmers Market Vouchers, and then proceed to spend their Farmers Market checks to purchase fresh produce from the farmers right there on the Health Department property!

Since the start of the Health Department Farmers Market Initiative on July 8th, the return rate of the Farmers Market checks has increased dramatically. This successful initiative means that

WIC participants are able to have easier access to fresh produce that promote their good health

local farmers are finding a new way to increase their selling capacity, which ultimately enhances the local economy.

You can find pictures from their Farmer’s Market on Facebook at the Central Shenandoah Health District and you can contact the Staunton Health Department at (540) 332-7830 to find out more information on who is able to receive these Farmers Market checks as well as ways you can help enhance their initiative.

You can also contact Project GROWS at http://www.projectgrows.org if you are looking to volunteer your time on the farm harvesting and tending to their beds!

It always feels good doing something to help out your community and volunteering with a local farm can provide a whole new appreciation for the fresh local food we are able to enjoy here in Virginia!

Photo 1: Jenna Clark, from Project GROWS, sets up for the first Health Department Farmers Market. Credit to the Facebook page of Central Shenandoah Health District.

Kat Huntley is a senior at James Madison University, where she majors in Dietetics and serves as the Vice President of the Dietetics Association. She enjoys being an engaged community member and looks to stay active in her volunteer work geared towards improving the equity of healthy food access. She has a passion for advocating for the health of the vulnerable and believes that food is a fundamental part of life that has the power to bring people together! Contact: huntleks@dukes.jmu.edu